Managing chronic kidney disease Nutrition is KEY

Dietary management may slow the progression of CKD, although there is some controversy as to when dietary intervention should be initiated and what diet to give. But once a patient is showing signs of uremia, it is a generally accepted practice to decrease the patient's phosphorus and protein intake to alleviate clinical signs. Following is a closer look at the effects of CKD and how proper nutrition can help. Muscle weakness may be caused by metabolic acidosis, a condition resulting from CKD that disrupts the body's acid-base balance. Anemia also causes weakness in patients with CKD. The kidneys produce the hormone erythropoietin, and erythropoietin stimulates the bone marrow to make red blood cells. In patients with this disease, the kidneys are no longer able to produce enough of the hormone and a nonregenerative anemia results. Not surprisingly, a loss of appetite is common in patients with CKD. Possible causes include dehydration, metabolic acidosis, anemia, and oral ulcers. Animals can display signs of nausea, such as vomiting, hypersalivation, lip smacking, or teeth grinding. Sniffing, licking, or looking at food and then turning away or trying to bury the food can be signs of a learned food aversion. A learned food aversion occurs when a pet becomes ill after eating and begins to associate feelings of nausea with eating. Overcoming a food aversion can be an arduous process. Antiemetic or prokinetic medication is often necessary to help a patient regain its appetite. Feeding patients with CKD a therapeutic diet containing a lower quantity of a highquality protein and reduced phosphorus concentrations may prolong their survival time, decrease uremic episodes, and slow the disease progression. Right now, no commercial pet foods are phosphorus-restricted - only veterinary therapeutic renal diets are. In addition, no commercial pet foods come close to the reduced protein concentration in veterinary therapeutic diets. Therefore, it is important to explain to clients the importance of feeding the prescribed therapeutic diet to pets with CKD.